<div class="ribbon">
    <a href=""><span class="home fa fa-home"></span></a>
    <ol class="breadcrumb">
        <li>费用报销申请表</li>
    </ol>
</div>

<div class="table-wrapper">
    <div class="toolbar">

    </div>
    <table class="table table-striped table-hover props table-sm table-bordered table-condensed">
        <tbody>
        <tr>
            <td width="8%" class="message text-center">部门</td>
            <td width="15%" class="message"><input type="text" class="form-control input-sm" placeholder="部门"></td>
            <td width="8%" class="message text-center">报销人</td>
            <td width="15%" class="message"><input type="text" class="form-control input-sm" placeholder="报销人"></td>
            <td width="8%" class="message text-center">代办人</td>
            <td width="15%" class="message"><input type="text" class="form-control input-sm" placeholder="代办人"></td>
            <td width="8%" class="message text-center">联系电话</td>
            <td width="15%" class="message"><input type="text" class="form-control input-sm" placeholder="联系电话"></td>
        </tr>
        <tr>
            <td class="message text-center">金额</td>
            <td class="message" colspan="3">
                <input type="text" class="form-control input-sm" placeholder="大写金额">
            </td>
            <td class="message text-center">小写</td>
            <td class="message"><input type="text" class="form-control input-sm" placeholder="小写金额"></td>
            <td class="message text-center">币种</td>
            <td class="message">
                <select type="text" class="form-control input-sm">
                    <option>CNY</option>
                    <option>USD</option>
                    <option>GBP</option>
                </select>
        </tr>
        <tr>
            <td class="message text-left" colspan="2">收款人/收款单位，开户银行及账号</td>
            <td class="message " colspan="6"><input type="text" class="form-control input-sm"></td>
        </tr>

        <tr>
            <td class="message text-center">支出类型</td>
            <td>
                <select type="text" class="form-control input-sm">
                    <option>车辆相关费用</option>
                    <option>业务费</option>
                    <option>办公费</option>
                    <option>办事处费用</option>
                    <option>其他费</option>
                </select>
            </td>
            <td class="message text-center">支出时间</td>
            <td class="message"><input type="text" class="form-control input-sm" placeholder="支出时间"></td>
            <td class="message text-center">支付方式</td>
            <td class="message" colspan="3">
                <div>
                    <ul >
                        <li style="float: left">
                            <div class="checkbox" >
                                <label>
                                    <input type="checkbox" >
                                    现金&nbsp;&nbsp;
                                </label>
                            </div>
                        </li>
                        <li style="float: left">
                            <div class="checkbox">
                                <label>
                                    <input type="checkbox" >
                                    银行卡&nbsp;&nbsp;
                                </label>
                            </div>
                        </li>
                        <li style="float: left">
                            <div class="checkbox">
                                <label>
                                    <input type="checkbox" >
                                    支票&nbsp;&nbsp;
                                </label>
                            </div>
                        </li>
                        <li style="float: left">
                            <div class="checkbox">
                                <label>
                                    <input type="checkbox" >
                                    票据&nbsp;&nbsp;
                                </label>
                            </div>
                        </li>
                        <li style="float: left">
                             <div class="checkbox">
                                <label>
                                    <input type="checkbox" >
                                     电汇&nbsp;&nbsp;
                                </label>
                             </div>
                        </li>
                        <li style="float: left">
                            <div class="checkbox">
                                <label>
                                    <input type="checkbox" >
                                    冲还借款&nbsp;&nbsp;
                                </label>
                            </div>
                        </li>
                    </ul>
                </div>


            </td>
        </tr>

        <tr>
            <td class="message text-center" >支出说明</td>
            <td height="80px" colspan="7" >
                <textarea rows="3" type="text" class="form-control" placeholder="请详细填写支出说明"></textarea>
            </td>
        </tr>
        <tr>
            <td class="message text-center" rowspan="2">审批签字</td>
            <td height="80px" colspan="3">
            <textarea rows="3" type="text" class="form-control" placeholder="部门审批意见"></textarea>
            </td>
            <td height="80px" colspan="2">
                <textarea rows="3" type="text" class="form-control" placeholder="凭证审批意见"></textarea>
            </td>
            <td height="80px" colspan="2">
                <textarea rows="3" type="text" class="form-control" placeholder="价格审批意见"></textarea>
            </td>
        </tr>
        <tr>
            <td height="80px" colspan="2">
                <textarea rows="3" type="text" class="form-control" placeholder="总经理签字"></textarea>
            </td>
            <td height="80px" colspan="2">
                <textarea rows="3" type="text" class="form-control" placeholder="财务终审签字"></textarea>
            </td>
            <td height="80px" colspan="4">
                <textarea rows="3" type="text" class="form-control" placeholder="董事长签字"></textarea>
            </td>
        </tr>
        </tbody>
    </table>
    <div class="toolbar">
        <form role="form">
            <button type="submit" class="btn btn-sm btn-primary pull-right">提交申请</button>
        </form>
    </div>
</div>


